高导电心脏补片电生理治疗的理论模型与临床结果预测研究

Abstract

Myocardial infarction (MI) impairs cardiac electrical signal transmission, which could be partially remedied by implantable electroactive biomaterials. Here we characterize electroactive cardiac patches (eCarPs) with conductivities spanning five orders of magnitude both in vitro and in rat models. In contrast to common belief, we reveal that highly conductive eCarPs are more effective in lowering the risk of post-MI arrhythmia and preserving cardiac function with respect to eCarPs with conductivity similar to normal myocardium. We show that highly conductive eCarPs restore electrical signal conduction velocity across infarcted myocardium to healthy levels, while less conductive eCarPs fail to do this. We quantitatively demonstrate that three-dimensional cardiac simulation based on the monodomain model accurately replicates the effect of high-conductivity patches in eliminating conduction blocks in porcine myocardium and the locations of reentrant circuits in patients with MI. Our results suggest that eCarP conductivity higher than healthy human myocardium is preferred for lowering the risk of arrhythmia in patients by reducing the number of reentrants and stabilizing the reentrant routes.